Evidence for risk of bias in cluster randomised trials: review of recent trials published in three general medical journals

Objective To examine the prevalence of a risk of bias associated with the design and conduct of cluster randomised controlled trials among a sample of recently published studies. Design Retrospective review of cluster randomised trials published in the BMJ, Lancet, and New England Journal of Medicine from January 1997 to October 2002. Main outcome measures Prevalence of secure randomisation of clusters, identification of participants before randomisation (to avoid foreknowledge of allocation), differential recruitment between treatment arms, differential application of inclusion and exclusion criteria, and differential attrition. Results Of the 36 trials identified, 24 were published in the BMJ, I I in the Lancet, and a single trial in the New England journal of Medicine. At the cluster level, 15 (42%) trials provided evidence for secure allocation and 25 (69%) used stratified allocation. Few trials showed evidence of imbalance at the cluster level. However, some evidence of susceptibility to risk of bias at the individual level existed in 14 (39%) studies. Conclusions Some recently published cluster randomised trials may not have taken adequate precautions to guard against threats to the internal validity of their design

Analytic solutions of the magnetic annihilation and reconnection problems. I. Planar flow profiles

The phenomena of steady-state magnetic annihilation and reconnection in the vicinity of magnetic nulls are considered. It is shown that reconnective solutions can be derived by superposing the velocity and magnetic fields of simple magnetic annihilation models. These solutions contain most of the previous models for magnetic merging and reconnection, as well as introducing several new solutions. The various magnetic dissipation mechanisms are classified by examining the scaling of the Ohmic diffusion rate with plasma resistivity. Reconnection solutions generally allow more favorable "fast" dissipation scalings than annihilation models. In particular, reconnection models involving the advection of planar field components have the potential to satisfy the severe energy release requirements of the solar flare. The present paper is mainly concerned with magnetic fields embedded in strictly planar flows—a discussion of the more complicated three-dimensional flow patterns is presented in Part II [Phys. Plasmas 4, 110 (1997)]

Spectra of Maser Radiation from a Turbulent, Circumnuclear Accretion Disk. III. Circular polarization

Calculations are performed for the circular polarization of maser radiation from a turbulent, Keplerian disk that is intended to represent the sub-parsec disk at the nucleus of the galaxy NGC4258. The polarization in the calculations is a result of the Zeeman effect in the regime in which the Zeeman splitting is much less than the spectral linebreadth. Plausible configurations for turbulent magnetic and velocity fields in the disk are created by statistical methods. This turbulence, along with the Keplerian velocity gradients and the blending of the three hyperfine components to form the $6_{16} - 5_{23}$ masing transition of water, are key ingredients in determining the appearance of the polarized spectra that are calculated. These spectra are quite different from the polarized spectra that would be expected for a two-level transition where there is no hyperfine structure. The effect of the hyperfine structure on the polarization is most striking in the calculations for the maser emission that represents the central (or systemic) features of NGC4258. Information about magnetic fields is inferred from observations for polarized maser radiation and bears on the structure of accretion disks.Comment: Latex, uses aastex, eucal, to be published in the Astrophysical Journa

Bessel beam propagation: Energy localization and velocity

The propagation of a Bessel beam (or Bessel-X wave) is analyzed on the basis of a vectorial treatment. The electric and magnetic fields are obtained by considering a realistic situation able to generate that kind of scalar field. Specifically, we analyze the field due to a ring-shaped aperture over a metallic screen on which a linearly polarized plane wave impinges. On this basis, and in the far field approximation, we can obtain information about the propagation of energy flux and the velocity of the energy.Comment: 6 pages, 4 figure

Ultraviolet degradation of thin films of zinc oxide

Ultraviolet degradation of zinc oxide thin film

Hall current effects in dynamic magnetic reconnection solutions

The impact of Hall current contributions on flow driven planar magnetic merging solutions is discussed. The Hall current is important if the dimensionless Hall parameter (or normalized ion skin depth) satisfies cH>η where η is the inverse Lundquist number for the plasma. A dynamic analysis of the problem shows, however, that the Hall current initially manifests itself, not by modifying the planar reconnection field, but by inducing a non-reconnecting perpendicular "separator" component in the magnetic field. Only if the stronger condition c2/H > η is satisfied can Hall currents be expected to affect the planar merging. These analytic predictions are then tested by performing a series of numerical experiments in periodic geometry, using the full system of planar magnetohydrodynamic (MHD) equations. The numerical results confirm that the nature of the merging changes dramatically when the Hall coupling satisfies c2/H > η. In line with the analytic treatment of sheared reconnection, the coupling provided by the Hall term leads to the emergence of multiple current layers that can enhance the global Ohmic dissipation at the expense of the reconnection rate. However, the details of the dissipation depend critically on the symmetries of the simulation, and when the merging is "head-on" (i.e., comprises fourfold symmetry) the reconnection rate can be enhanced

Annona muricata (graviola): toxic or therapeutic

This paper examines annona muricata (graviola): toxic or therapeutic

Experience of domestic violence by women attending an inner city accident and emergency department.

OBJECTIVES: To identify the prevalence of domestic violence (DV) (defined as physical abuse perpetrated by intimate partners) in women attending an inner city accident and emergency department and to elicit women's response about being asked routinely about domestic violence in this setting. METHODS: 22 nursing shifts were purposefully sampled to be representative of day, night, and weekends. A questionnaire was administered to 198 consenting women who were not intoxicated, confused, or critically ill. RESULTS: The prevalence of acute trauma in women attributable to DV was 1% (95%CI 0.14 to 3.6), the prevalence of lifetime physical abuse was 34.8% (95%CI 28.2 to 41.5), of past year physical abuse was 6.1% (95%CI 3.2 to 10.3), and of lifetime life threatening physical abuse was 10.6% (95%CI 6.3 to 14.9). Seventy six per cent of women felt comfortable about being asked about DV and 60.5% of women felt that they should always or usually be asked about DV in this setting. CONCLUSION: This cross sectional survey adds to the body of knowledge showing that the prevalence of DV in women attending an accident and emergency department is high. Most women were in favour of being asked, and disclosure was associated with discomfort in few women. This sensitive area of history taking and referral could be undertaken by health professionals using a supportive approach

Gamma-Ray Bursts observed by XMM-Newton

Analysis of observations with XMM-Newton have made a significant contribution to the study of Gamma-ray Burst (GRB) X-ray afterglows. The effective area, bandpass and resolution of the EPIC instrument permit the study of a wide variety of spectral features. In particular, strong, time-dependent, soft X-ray emission lines have been discovered in some bursts. The emission mechanism and energy source for these lines pose major problems for the current generation of GRB models. Other GRBs have intrinsic absorption, possibly related to the environment around the progenitor, or possible iron emission lines similar to those seen in GRBs observed with BeppoSAX. Further XMM-Newton observations of GRBs discovered by the Swift satellite should help unlock the origin of the GRB phenomenon over the next few years.Comment: To appear in proceedings of the "XMM-Newton EPIC Consortium meeting, Palermo, 2003 October 14-16", published in Memorie della Societa Astronomica Italian