Clinical Trial Results Summary for Laypersons: A User Testing Study

Objective: To apply “user testing” to maximize readability and acceptability of a Clinical Trial Results Laypersons Summary—a new European requirement. Methods: “User testing” (using questionnaire and semistructured interview) assessed whether people could find and understand key points. Findings were used to improve content and design, prior to retesting. Participants had a range of levels of health literacy and there was a higher education group. Participants accessed the summary on screen. In round 1 we tested 12 points of information. In round 2 a revised summary addressing round 1 findings was tested, leading to a third final version. Results: In round 1, 2 of 12 points of information did not reach the target and interviews raised further format and content issues (some distracting technical explanations and inability to find or understand the 2 main study purposes). These findings informed revisions for the version tested in round 2, with 2 different points not reaching the target (inclusion criteria relating to duration of seasonal allergies and how researchers found out about participants’ symptoms). Identified problems in both rounds were addressed and reflected in the final version. Despite improvements, participants did not consistently understand that summaries were intended for the public, or to only interpret results of single trials in the context of additional trials. All readers, including those with higher education, found the clear and straightforward language acceptable. Conclusions: Applying “user testing” resulted in a largely health-literate summary suitable for people across a range of backgrounds

Development of Ultrasonic Inspection for a Bonded Superalloy Blade

Directionally solidified multigrain and single crystal airfoils have been used in aircraft gas turbines for over ten years and are currently found in aircraft engine-derivative gas turbines used for land-based power generation. However, the adoption of this technology for large land-based gas turbines is just underway and is not a simple scale-up. One approach to produce the large blades required for this application involves casting the blade in two separate halves and then bonding these halves together using the transient liquid phase bonding (TLPB) process [1]. This process results in a number of internal bond surfaces at the ribs. The condition of these bond surfaces must be determined prior to the blade entering service.</p

Fractional quantum Hall effect measures at zero g factor

Fractional quantum Hall effect energy gaps have been measured as a function of Zeeman energy. The gap at ν = 1/3 decreases as the g factor is reduced by hydrostatic pressure. This behavior is similar to that at ν = 1 and shows that the excitations are spinlike. At small Zeeman energy, the excitation is consistent with the reversal of 3 spins and may be interpreted as a small composite Skyrmion. At 20 kbar, where g has changed sign, the 1/3 gap appears to increase again

Experimentally manipulated self-affirmation promotes reduced alcohol consumption in response to narrative information

Background: Health-risk information is increasingly being conveyed through accounts of personal experiences or narrative information. However, whether self-affirmation can enhance the ability of such messages to promote behavior change has yet to be established. Purpose: This study aims to test whether self-affirmation (a) promotes behavior change following exposure to narrative information about the risks of excessive alcohol consumption and (b) boosts message acceptance by increasing narrative engagement. Methods: In an experimental design, female drinkers (N = 142) reported their baseline alcohol consumption and were randomly allocated to condition (Self-Affirmation, Control). All participants next watched an extract of a genuine narrative piece in which the central character discussed her liver disease and its link with her previous alcohol consumption. Then, participants completed measures assessing engagement with the narrative and message acceptance. The primary outcome was alcohol consumption, assessed at 7-day follow-up. Results: Self-affirmed participants reported consuming significantly less alcohol at follow-up compared to baseline (mean 7-day decrease = 5.43 units); there was no change in alcohol consumption for the control group. Immediately post-manipulation, self-affirmed participants (vs. control) showed more message acceptance and reported greater engagement with the information. The impact of self-affirmation on message acceptance was mediated by narrative engagement. Conclusions: Self-affirmation can promote behavior change following exposure to health information, even when presented in narrative form

Quality Indicators for Colonoscopy Procedures: A Prospective Multicentre Method for Endoscopy Units

BACKGROUND AND AIMS: Healthcare professionals are required to conduct quality control of endoscopy procedures, and yet there is no standardised method for assessing quality. The topic of the present study was to validate the applicability of the procedure in daily practice, giving physicians the ability to define areas for continuous quality improvement. METHODS: In ten endoscopy units in France, 200 patients per centre undergoing colonoscopy were enrolled in the study. An evaluation was carried out based on a prospectively developed checklist of 10 quality-control indicators including five dependent upon and five independent of the colonoscopy procedure. RESULTS: Of the 2000 procedures, 30% were done at general hospitals, 20% at university hospitals, and 50% in private practices. The colonoscopies were carried out for a valid indication for 95.9% (range 92.5-100). Colon preparation was insufficient in 3.7% (range 1-10.5). Colonoscopies were successful in 95.3% (range 81-99). Adenoma detection rate was 0.31 (range 0.17-0.45) in successful colonoscopies. CONCLUSION: This tool for evaluating the quality of colonoscopy procedures in healthcare units is based on standard endoscopy and patient criteria. It is an easy and feasible procedure giving the ability to detect suboptimal practice and differences between endoscopy-units. It will enable individual units to assess the quality of their colonoscopy techniques

Extension of non-minimal derivative coupling theory and Hawking radiation in black-hole spacetime

We study the greybody factor and Hawking radiation with a non-minimal derivative coupling between the scalar field and the curvature in the background of the slowly rotating Kerr-Newman black hole. Our results show that both the absorption probability and luminosity of Hawking radiation of the scalar field increase with the coupling. Moreover, we also find that for the weak coupling $\eta<\eta_c$, the absorption probability and luminosity of Hawking radiation decrease when the black hole's Hawking temperature decreases; while for stronger coupling $\eta>\eta_c$, the absorption probability and luminosity of Hawking radiation increase on the contrary when the black hole's Hawking temperature decreases. This feature is similar to the Hawking radiation in a $d$-dimensional static spherically-symmetric black hole surrounded by quintessence \cite{chensong}.Comment: 17 pages, 6 figures, 1 table, Title changed, Appendix changed, accepted by JHE

Blocking TLR7- and TLR9-mediated IFN-α Production by Plasmacytoid Dendritic Cells Does Not Diminish Immune Activation in Early SIV Infection

Persistent production of type I interferon (IFN) by activated plasmacytoid dendritic cells (pDC) is a leading model to explain chronic immune activation in human immunodeficiency virus (HIV) infection but direct evidence for this is lacking. We used a dual antagonist of Toll-like receptor (TLR) 7 and TLR9 to selectively inhibit responses of pDC but not other mononuclear phagocytes to viral RNA prior to and for 8 weeks following pathogenic simian immunodeficiency virus (SIV) infection of rhesus macaques. We show that pDC are major but not exclusive producers of IFN-α that rapidly become unresponsive to virus stimulation following SIV infection, whereas myeloid DC gain the capacity to produce IFN-α, albeit at low levels. pDC mediate a marked but transient IFN-α response in lymph nodes during the acute phase that is blocked by administration of TLR7 and TLR9 antagonist without impacting pDC recruitment. TLR7 and TLR9 blockade did not impact virus load or the acute IFN-α response in plasma and had minimal effect on expression of IFN-stimulated genes in both blood and lymph node. TLR7 and TLR9 blockade did not prevent activation of memory CD4+ and CD8+ T cells in blood or lymph node but led to significant increases in proliferation of both subsets in blood following SIV infection. Our findings reveal that virus-mediated activation of pDC through TLR7 and TLR9 contributes to substantial but transient IFN-α production following pathogenic SIV infection. However, the data indicate that pDC activation and IFN-α production are unlikely to be major factors in driving immune activation in early infection. Based on these findings therapeutic strategies aimed at blocking pDC function and IFN-α production may not reduce HIV-associated immunopathology. © 2013 Kader et al

Color & Weak triplet scalars, the dimuon asymmetry in BsB_s decay, the top forward-backward asymmetry, and the CDF dijet excess

The new physics required to explain the anomalies recently reported by the D0 and CDF collaborations, namely the top forward-backward asymmetry (FBA), the like-sign dimuon charge asymmetry in semileptonic b decay, and the CDF dijet excess, has to feature an amount of flavor symmetry in order to satisfy the severe constrains arising from flavor violation. In this paper we show that, once baryon number conservation is imposed, color & weak triplet scalars with hypercharge $Y=1/3$ can feature the required flavor structure as a consequence of standard model gauge invariance. The color & weak triplet model can simultaneously explain the top FBA and the dimuon charge asymmetry or the dimuon charge asymmetry and the CDF dijet excess. However, the CDF dijet excess appears to be incompatible with the top FBA in the minimal framework. Our model for the dimuon asymmetry predicts the observed pattern $h_d\ll h_s$ in the region of parameter space required to explain the top FBA, whereas our model for the CDF dijet anomaly is characterized by the absence of beyond the SM b-quark jets in the excess region. Compatibility of the color & weak triplet with the electroweak constraints is also discussed. We show that a Higgs boson mass exceeding the LEP bound is typically favored in this scenario, and that both Higgs production and decay can be significantly altered by the triplet. The most promising collider signature is found if the splitting among the components of the triplet is of weak scale magnitude.Comment: references added, published versio

Interplay between pleiotropy and secondary selection determines rise and fall of mutators in stress response

Dramatic rise of mutators has been found to accompany adaptation of bacteria in response to many kinds of stress. Two views on the evolutionary origin of this phenomenon emerged: the pleiotropic hypothesis positing that it is a byproduct of environmental stress or other specific stress response mechanisms and the second order selection which states that mutators hitchhike to fixation with unrelated beneficial alleles. Conventional population genetics models could not fully resolve this controversy because they are based on certain assumptions about fitness landscape. Here we address this problem using a microscopic multiscale model, which couples physically realistic molecular descriptions of proteins and their interactions with population genetics of carrier organisms without assuming any a priori fitness landscape. We found that both pleiotropy and second order selection play a crucial role at different stages of adaptation: the supply of mutators is provided through destabilization of error correction complexes or fluctuations of production levels of prototypic mismatch repair proteins (pleiotropic effects), while rise and fixation of mutators occur when there is a sufficient supply of beneficial mutations in replication-controlling genes. This general mechanism assures a robust and reliable adaptation of organisms to unforeseen challenges. This study highlights physical principles underlying physical biological mechanisms of stress response and adaptation