Cancer risk assessment tools for symptomatic individuals presenting to primary care: a systematic scoping review

Cancer risk assessment tools for symptomatic individuals presenting to primary care: a systematic scoping review ABSTRACT CANCER RISK ASSESSMENT TOOLS FOR SYMPTOMATIC INDIVIDUALS PRESENTING TO PRIAMRY CARE: A SYSTEMATIC SCOPING REVIEW Background: Novel cancer risk assessment tools, designed to predict cancer risk in symptomatic individuals in primary care settings, are being advocated to address the problem of late diagnosis of cancer in the UK. Despite this, little is known about the use and implementation of cancer risk assessment tools to aid early detection of cancer risk in general practice. We aimed to scope the evidence on the type of cancer risk assessment tools available for symptomatic individuals, and the current use of the tools including the benefits and barriers to their use. Methods: Using Arksey and O’Malley’s framework, we conducted a systematic scoping review of published literature in the English language from 2004 to 2017. We searched six electronic databases (Medline, CINAHL, Scopus, Cochrane, Science Direct and Psych-INFO) using specific search terms. A narrative synthesis was used to summarise the findings from the studies identified. Results: We retrieved a total of 471 papers from the electronic databases and 43 matched the inclusion criteria. Novel cancer risk assessment tools for symptomatic individuals in primary care identified from the review included the QCancer and RAT series. While there was some evidence supporting use of some of the tools, there was limited evidence on the current use and the impact of using the tools on patient outcomes such as rates of cancer diagnosis and survival. There was also some evidence on potential benefits (potential aid for clinicians to confirm investigations and referral decisions, for reassurance of patients when investigation not needed, helping GPs to recognise symptoms of some cancers and useful for detecting cancer risk in patients with complex histories) and barriers to using the tools in primary care consultations. As the review found, the following barriers to use of the tools would need to be addressed for effective implementation of the tools in primary care: how to make the tools available to clinicians, how best to communicate cancer risk information to patients, uncertainty about the threshold for action to be taken, extra consultation time requirement, potential for causing alarm to patients, potential burden on resources, a challenge about integrating the tools into general practice workflow and a potential for ‘prompt fatigue. Conclusion: The review revealed evidence of novel cancer risk assessment tools designed for symptomatic individuals in primary care. There was also evidence on potential benefits and barriers relating to the use of the tools. There is a need to address the barriers identified when implementing the tools in general consultations

The fermion dynamical symmetry model for the even--even and even--odd nuclei in the Xe--Ba region

The even--even and even--odd nuclei $^{126}$Xe-$^{132}$Xe and $^{131}$Ba-$^{137}$Ba are shown to have a well-realized $SO_8 \supset SO_6 \supset SO_3$ fermion dynamical symmetry. Their low-lying energy levels can be described by a unified analytical expression with two (three) adjustable parameters for even--odd (even--even) nuclei that is derived from the fermion dynamical symmetry model. Analytical expressions are given for wavefunctions and for $E2$ transition rates that agree well with data. The distinction between the FDSM and IBM $SO_6$ limits is discussed. The experimentally observed suppression of the the energy levels with increasing $SO_5$ quantum number $\tau$ can be explained as a perturbation of the pairing interaction on the $SO_6$ symmetry, which leads to an $SO_5$ Pairing effect for $SO_6$ nuclei.Comment: submitted to Phys. Rev. C, LaTeX, 31 pages, 8 figures with postscript files available on request at [email protected]

Development of the Critical Thinking Toolkit (CriTT): a measure of student attitudes and beliefs about critical thinking

Critical thinking is an important focus in higher education and is essential for good academic achievement. We report the development of a tool to measure critical thinking for three purposes: (i) to evaluate student perceptions and attitudes about critical thinking, (ii) to identify students in need of support to develop their critical thinking, and (iii) to predict academic performance. Seventy-seven items were generated from focus groups, interviews and the critical thinking literature. Data were collected from 133 psychology students. Factor Analysis revealed three latent factors based on a reduced set of 27 items. These factors were characterised as: Confidence in Critical Thinking; Valuing Critical Thinking; and Misconceptions. Reliability analysis demonstrated that the sub-scales were reliable. Convergent validity with measures of grade point average and argumentation skill was shown, with significant correlations between subscales and validation measures. Most notably, in multiple regression analysis, the three sub-scales from the new questionnaire substantially increased the variance in grade point average accounted for by measures of reflective thinking and argumentation. To sum, the resultant scale offers a measure that is simple to administer, can be used as a diagnostic tool to identify students who need support in developing their critical thinking skills, and can also predict academic performance

Neutrino Masses with "Zero Sum" Condition: mν1+mν2+mν3=0m_{\nu_1} + m_{\nu_2} + m_{\nu_3} = 0

It is well known that the neutrino mass matrix contains more parameters than experimentalists can hope to measure in the foreseeable future even if we impose CP invariance. Thus, various authors have proposed ansatzes to restrict the form of the neutrino mass matrix further. Here we propose that $m_{\nu_1} + m_{\nu_2} + m_{\nu_3} = 0$; this ``zero sum'' condition can occur in certain class of models, such as models whose neutrino mass matrix can be expressed as commutator of two matrices. With this condition, the absolute neutrino mass can be obtained in terms of the mass-squared differences. When combined with the accumulated experimental data this condition predicts two types of mass hierarchies, with one of them characterized by $m_{\nu_3} \approx -2m_{\nu_1} \approx -2 m_{\nu_2} \approx 0.063$ eV, and the other by $m_{\nu_1} \approx -m_{\nu_2} \approx 0.054$ eV and $m_{\nu_3} \approx 0.0064$ eV. The mass ranges predicted is just below the cosmological upper bound of 0.23 eV from recent WMAP data and can be probed in the near future. We also point out some implications for direct laboratory measurement of neutrino masses, and the neutrino mass matrix.Comment: Latex 12 pages. No figures. New references adde

High-gradient normal-conducting RF structures for muon cooling channels

We present a status report on the research and development of high-gradient normal-conducting RF structures for the ionization cooling of muons in a neutrino factory or muon collider. High-gradient RF structures are required in regions enclosed in strong focusing solenoidal magnets, precluding the application of superconducting RF technology [1]. We propose using linear accelerating structures, with individual cells electromagnetically isolated, to achieve the required gradients of over 15 MV/m at 201 MHz and 30 MV/m at 805 MHz. Each cell will be powered independently, and cell length and drive phase adjusted to optimize shunt impedance of the assembled structure. This efficient design allows for relatively small field enhancement on the structure walls, and an accelerating field approximately 1.7 times greater than the peak surface field. The electromagnetic boundary of each cell may be provided by a thin Be sheet, or an assembly of thin-walled metal tubes. Use of thin, low-Z materials will allow passage of the muon beams without significant deterioration in beam quality due to scattering. R and D in design and analysis of robust structures that will operate under large electric and magnetic fields and RF current heating are discussed, including the experimental program based in a high-power test laboratory developed for this purpose

Measurement of the polarisation of W bosons produced with large transverse momentum in pp collisions at sqrt(s) = 7 TeV with the ATLAS experiment

This paper describes an analysis of the angular distribution of W->enu and W->munu decays, using data from pp collisions at sqrt(s) = 7 TeV recorded with the ATLAS detector at the LHC in 2010, corresponding to an integrated luminosity of about 35 pb^-1. Using the decay lepton transverse momentum and the missing transverse energy, the W decay angular distribution projected onto the transverse plane is obtained and analysed in terms of helicity fractions f0, fL and fR over two ranges of W transverse momentum (ptw): 35 < ptw < 50 GeV and ptw > 50 GeV. Good agreement is found with theoretical predictions. For ptw > 50 GeV, the values of f0 and fL-fR, averaged over charge and lepton flavour, are measured to be : f0 = 0.127 +/- 0.030 +/- 0.108 and fL-fR = 0.252 +/- 0.017 +/- 0.030, where the first uncertainties are statistical, and the second include all systematic effects.Comment: 19 pages plus author list (34 pages total), 9 figures, 11 tables, revised author list, matches European Journal of Physics C versio

Observation of a new chi_b state in radiative transitions to Upsilon(1S) and Upsilon(2S) at ATLAS

The chi_b(nP) quarkonium states are produced in proton-proton collisions at the Large Hadron Collider (LHC) at sqrt(s) = 7 TeV and recorded by the ATLAS detector. Using a data sample corresponding to an integrated luminosity of 4.4 fb^-1, these states are reconstructed through their radiative decays to Upsilon(1S,2S) with Upsilon->mu+mu-. In addition to the mass peaks corresponding to the decay modes chi_b(1P,2P)->Upsilon(1S)gamma, a new structure centered at a mass of 10.530+/-0.005 (stat.)+/-0.009 (syst.) GeV is also observed, in both the Upsilon(1S)gamma and Upsilon(2S)gamma decay modes. This is interpreted as the chi_b(3P) system.Comment: 5 pages plus author list (18 pages total), 2 figures, 1 table, corrected author list, matches final version in Physical Review Letter

Search for displaced vertices arising from decays of new heavy particles in 7 TeV pp collisions at ATLAS

We present the results of a search for new, heavy particles that decay at a significant distance from their production point into a final state containing charged hadrons in association with a high-momentum muon. The search is conducted in a pp-collision data sample with a center-of-mass energy of 7 TeV and an integrated luminosity of 33 pb^-1 collected in 2010 by the ATLAS detector operating at the Large Hadron Collider. Production of such particles is expected in various scenarios of physics beyond the standard model. We observe no signal and place limits on the production cross-section of supersymmetric particles in an R-parity-violating scenario as a function of the neutralino lifetime. Limits are presented for different squark and neutralino masses, enabling extension of the limits to a variety of other models.Comment: 8 pages plus author list (20 pages total), 8 figures, 1 table, final version to appear in Physics Letters

Measurement of the inclusive isolated prompt photon cross-section in pp collisions at sqrt(s)= 7 TeV using 35 pb-1 of ATLAS data

A measurement of the differential cross-section for the inclusive production of isolated prompt photons in pp collisions at a center-of-mass energy sqrt(s) = 7 TeV is presented. The measurement covers the pseudorapidity ranges |eta|<1.37 and 1.52<=|eta|<2.37 in the transverse energy range 45<=E_T<400GeV. The results are based on an integrated luminosity of 35 pb-1, collected with the ATLAS detector at the LHC. The yields of the signal photons are measured using a data-driven technique, based on the observed distribution of the hadronic energy in a narrow cone around the photon candidate and the photon selection criteria. The results are compared with next-to-leading order perturbative QCD calculations and found to be in good agreement over four orders of magnitude in cross-section.Comment: 7 pages plus author list (18 pages total), 2 figures, 4 tables, final version published in Physics Letters