Developing Integrated Clinical Pathways for the Management of Clinically Severe Adult Obesity: a Critique of NHS England Policy

Purpose of the Review: Pathways for obesity prevention and treatment are well documented, yet the prevalence of obesity is rising, and access to treatment (including bariatric surgery) is limited. This review seeks to assess the current integrated clinical pathway for obesity management in England and determine the major challenges. Recent Findings: Evidence for tier 2 (community-based lifestyle intervention) and tier 3 (specialist weight management services) is limited, and how it facilitates care and improve outcomes in tier 4 remains uncertain. Treatment access, rigidity in pathways, uncertain treatment outcomes and weight stigma seems to be major barriers to improved care. Summary: More emphasis must be placed on access to effective treatments, treatment flexibility, addressing stigma and ensuring treatment efficacy including long-term health outcomes. Prevention and treatment should both receive significant focus though should be considered to be largely separate pathways. A simplified system for weight management is needed to allow flexibility and the delivery of personalized care including post-bariatric surgery care for those who need it

No triangles on the moduli space of maximally supersymmetric gauge theory

Maximally supersymmetric gauge theory in four dimensions has a remarkably simple S-matrix at the origin of its moduli space at both tree and loop level. This leads to the question what, if any, of this structure survives at the complement of this one point. Here this question is studied in detail at one loop for the branch of the moduli space parameterized by a vacuum expectation value for one complex scalar. Motivated by the parallel D-brane picture of spontaneous symmetry breaking a simple relation is demonstrated between the Lagrangian of broken super Yang-Mills theory and that of its higher dimensional unbroken cousin. Using this relation it is proven both through an on- as well as an off-shell method there are no so-called triangle coefficients in the natural basis of one-loop functions at any finite point of the moduli space for the theory under study. The off-shell method yields in addition absence of rational terms in a class of theories on the Coulomb branch which includes the special case of maximal supersymmetry. The results in this article provide direct field theory evidence for a recently proposed exact dual conformal symmetry motivated by the AdS/CFT correspondence.Comment: 39 pages, 4 figure

Analysis of Cattle Social Transitional Behaviour: Attraction and Repulsion.

Understanding social interactions in livestock groups could improve management practices, but this can be difficult and time-consuming using traditional methods of live observations and video recordings. Sensor technologies and machine learning techniques could provide insight not previously possible. In this study, based on the animals' location information acquired by a new cooperative wireless localisation system, unsupervised machine learning approaches were performed to identify the social structure of a small group of cattle yearlings (n=10) and the social behaviour of an individual. The paper first defined the affinity between an animal pair based on the ranks of their distance. Unsupervised clustering algorithms were then performed, including K-means clustering and agglomerative hierarchical clustering. In particular, K-means clustering was applied based on logical and physical distance. By comparing the clustering result based on logical distance and physical distance, the leader animals and the influence of an individual in a herd of cattle were identified, which provides valuable information for studying the behaviour of animal herds. Improvements in device robustness and replication of this work would confirm the practical application of this technology and analysis methodologies

Dimensions of professional competences for interventions towards sustainability

This paper investigates sustainability competences through the eyes of professional practitioners in the field of sustainability and presents empirical data that have been created using an action research approach. The design of the study consists of two workshops, in which professional practitioners in interaction with each other and the facilitators are invited to explore and reflect on the specific knowledge, skills, attitudes and behaviours necessary to conduct change processes successfully towards sustainability in a variety of business and professional contexts. The research focuses on the competences associated with these change processes to devise, propose and conduct appropriate interventions that address sustainability issues. Labelled ‘intervention competence’, this ability comprises an interlocking set of knowledge, skills, attitudes and behaviours that include: appreciating the importance of (trying to) reaching decisions or interventions; being able to learn from lived experience of practice and to connect such learning to one’s own scientific knowledge; being able to engage in political-strategic thinking, deliberations and actions, related to different perspectives; the ability for showing goal-oriented, adequate action; adopting and communicating ethical practices during the intervention process; being able to cope with the degree of complexity, and finally being able to translate stakeholder diversity into collectively produced interventions (actions) towards sustainability. Moreover, this competence has to be practised in contexts of competing values, non-technical interests and power relations. The article concludes with recommendations for future research and practice

Classical integrability and quantum aspects of the AdS(3) x S(3) x S(3) x S(1) superstring

In this paper we continue the investigation of aspects of integrability of the type IIA AdS(3) x S(3) x S(3) x S(1) and AdS(3) x S(3) x T(4) superstrings. By constructing a one parameter family of flat connections we prove that the Green-Schwarz string is classically integrable, at least to quadratic order in fermions, without fixing the kappa-symmetry. We then compare the quantum dispersion relation, fixed by integrability up to an unknown interpolating function h(lambda), to explicit one-loop calculations on the string worldsheet. For AdS(3) x S(3) x S(3) x S(1) the spectrum contains heavy, as well as light and massless modes, and we find that the one-loop contribution differs depending on how we treat these modes showing that similar regularization ambiguities as appeared in AdS(4)/CFT(3) occur also here.Comment: 29 pages; v2: updated references and acknowledgmen

Finite-gap equations for strings on AdS_3 x S^3 x T^4 with mixed 3-form flux

We study superstrings on AdS_3 x S^3 x T^4 supported by a combination of Ramond-Ramond and Neveu-Schwarz-Neveu-Schwarz three form fluxes, and construct a set of finite-gap equations that describe the classical string spectrum. Using the recently proposed all-loop S-matrix we write down the all-loop Bethe ansatz equations for the massive sector. In the thermodynamic limit the Bethe ansatz reproduces the finite-gap equations. As part of this derivation we propose expressions for the leading order dressing phases. These phases differ from the well-known Arutyunov-Frolov-Staudacher phase that appears in the pure Ramond-Ramond case. We also consider the one-loop quantization of the algebraic curve and determine the one-loop corrections to the dressing phases. Finally we consider some classical string solutions including finite size giant magnons and circular strings.Comment: 44 pages, 3 figures. v2: references and a discussion about perturbative results adde

Jet Dipolarity: Top Tagging with Color Flow

A new jet observable, dipolarity, is introduced that can distinguish whether a pair of subjets arises from a color singlet source. This observable is incorporated into the HEPTopTagger and is shown to improve discrimination between top jets and QCD jets for moderate to high pT.Comment: 8 pages, 6 figures (updated to JHEP version

On BCFW shifts of integrands and integrals

In this article a first step is made towards the extension of Britto-Cachazo-Feng-Witten (BCFW) tree level on-shell recursion relations to integrands and integrals of scattering amplitudes to arbitrary loop order. Surprisingly, it is shown that the large BCFW shift limit of the integrands has the same structure as the corresponding tree level amplitude in any minimally coupled Yang-Mills theory in four or more dimensions. This implies that these integrands can be reconstructed from a subset of their `single cuts'. The main tool is powercounting Feynman graphs in a special lightcone gauge choice employed earlier at tree level by Arkani-Hamed and Kaplan. The relation between shifts of integrands and shifts of its integrals is investigated explicitly at one loop. Two particular sources of discrepancy between the integral and integrand are identified related to UV and IR divergences. This is cross-checked with known results for helicity equal amplitudes at one loop. The nature of the on-shell residue at each of the single-cut singularities of the integrand is commented upon. Several natural conjectures and opportunities for further research present themselves.Comment: 43 pages, 6 figures, v2: minor improvement in exposition, typos fixed, bibliography update

Non-thermal emission processes in massive binaries

In this paper, I present a general discussion of several astrophysical processes likely to play a role in the production of non-thermal emission in massive stars, with emphasis on massive binaries. Even though the discussion will start in the radio domain where the non-thermal emission was first detected, the census of physical processes involved in the non-thermal emission from massive stars shows that many spectral domains are concerned, from the radio to the very high energies. First, the theoretical aspects of the non-thermal emission from early-type stars will be addressed. The main topics that will be discussed are respectively the physics of individual stellar winds and their interaction in binary systems, the acceleration of relativistic electrons, the magnetic field of massive stars, and finally the non-thermal emission processes relevant to the case of massive stars. Second, this general qualitative discussion will be followed by a more quantitative one, devoted to the most probable scenario where non-thermal radio emitters are massive binaries. I will show how several stellar, wind and orbital parameters can be combined in order to make some semi-quantitative predictions on the high-energy counterpart to the non-thermal emission detected in the radio domain. These theoretical considerations will be followed by a census of results obtained so far, and related to this topic... (see paper for full abstract)Comment: 47 pages, 5 postscript figures, accepted for publication in Astronomy and Astrophysics Review. Astronomy and Astrophysics Review, in pres