State Estimation in the Cerebellum

An exciting hypothesis about the cerebellum is that its role is one of state estimation—a process that combines afferent copies of motor commands with afferent sensory signals to produce a representation of the current status of the peripheral motor system. Sensory inputs alone cannot provide a perfect state signal because of inevitable delays in their afferent pathways. We have recently reported the effects of transcranial magnetic stimulation (TMS) over the ipsilateral cerebellum as healthy subjects made rapid reaching movements towards visually defined targets (Miall et al. in PLoS Biology 5:2733–2744, 2007). Errors in the initial direction and in the final finger position of this reachto-target movement were consistent with the reaching movements being planned and initiated from an estimated hand position that was about 138 ms out of date. This interval is consistent with estimates of the delays in sensory motor pathways that would inform the central nervous system of the peripheral status. We now report new data using the same paradigm, testing the effects of varying the TMS stimulus train from one, two, or three pulses. We show that the errors in movement are relatively insensitive to the TMS pulse-train duration. The estimated time interval by which the hand position is mislocalized varied by only 12 ms as the TMS train duration increased by 100 ms. Thus, this interval is likely to reflect physiological processes within the cerebellum rather than the TMSstimulus duration. This new evidence supports our earlier claim that the cerebellum is responsible for predictively updating a central state estimate over an interval of about 120–140 ms. Dysfunction of the cerebellum, whether through disease or experimental procedures, leads to motor errors consistent with a loss of knowledge of the true state of the motor system

“No we can’t use less words! Or can we?” Reflections on a journey into e-learning

Academics used to traditional styles of writing and presenting material are likely to find developing e-learning materials an unsettling experience. E-learning experts provide invaluable support throughout the process, but their guidance and feedback sounds uncannily like our advice to students: ‘What you are trying to do is far too ambitious!’; ‘What is the point you are making here?’ ‘Is all this detail necessary?’ The potential of e-learning for creative design is exciting, even seductive, until you are told that the image that links to the carefully crafted text does not work! This paper draws on our shared experiences, as academics and e-learning designers, of developing a set of e-learning objects on communication skills. Our collaboration has highlighted many challenges in the process of writing for e-learning. For example: • Determining the scope of a learning object and selecting appropriate content • Making the content engaging and interactive to hold the user’s attention • Using activities rather than text as the main vehicle for learning • Including all the information the user will need to achieve the learning objectives • Explaining complex points in simple and concise language • Choosing images and other design features that link effectively to the text • Adjusting to non-linear approaches to learning. Tackling these challenges has prompted us to rethink our teaching. We are now conscious of how our teaching materials rely on our presence to enthuse, to explain and to fill in the gaps. We have become more confident in our ability to convey complex ideas in simple language and more willing to experiment with creative and interactive forms of presentation. Most important of all we have been forced to rethink our assumptions about what is meant by a sound learning experience

Changing health behaviors using financial incentives: a review from behavioral economics

Background: Incentives are central to economics and are used across the public and private sectors to influence behavior. Recent interest has been shown in using financial incentives to promote desirable health behaviors and discourage unhealthy ones. Main text: If we are going to use incentive schemes to influence health behaviors, then it is important that we give them the best chance of working. Behavioral economics integrates insights from psychology with the laws of economics and provides a number of robust psychological phenomena that help to better explain human behavior. Individuals' decisions in relation to incentives may be shaped by more subtle features - such as loss aversion, overweighting of small probabilities, hyperbolic discounting, increasing payoffs, reference points - many of which have been identified through research in behavioral economics. If incentives are shown to be a useful strategy to influence health behavior, a wider discussion will need to be had about the ethical dimensions of incentives before their wider implementation in different health programmes. Conclusions: Policy makers across the world are increasingly taking note of lessons from behavioral economics and this paper explores how key principles could help public health practitioners design effective interventions both in relation to incentive designs and more widely

Intercomparison of surface velocimetry techniques for drone-based marine current characterization

Mapping tidal currents is important for a variety of coastal and marine applications. Deriving current maps from in-situ measurements is difficult due to spatio-temporal separation of measurement points. Therefore, low-cost remote sensing tools such as drone-based surface velocimetry are attractive. Previous application of particle image velocimetry to tidal current measurements demonstrated that accuracy depends on site and environmental conditions. This study compares surface velocimetry techniques across a range of these conditions. Various open-source tools and image pre-processing methods were applied to six sets of videos and validation data that cover a variety of site and weather conditions. When wind-driven ripples are present in imagery, it was found a short-wave celerity inversion performed best, with mean absolute percentage error (MAPE) of 5–6% compared to surface drifters. During lower wind speeds, current-advected surface features are visible and techniques which track these work best, of which the most appropriate technique depends on specifics of the collected imagery; MAPEs of 9–21% were obtained. This work has quantified accuracy and demonstrated that surface current maps can be obtained from drones under both high and low wind speeds and at a variety of sites. By following these suggested approaches, practitioners can use drones as a current mapping tool at coastal and offshore sites with confidence in the outputs

What is on Tap? The Role of Spin in Compact Objects and Relativistic Jets

We examine the role of spin in launching jets from compact objects across the mass scale. Our work includes a total of 37 Seyferts, 11 stellar-mass black holes, and 13 neutron stars. We find that when the Seyfert reflection lines are modeled with Gaussian line features (a crude proxy for inner disk radius and therefore spin), only a slight inverse correlation is found between the Doppler-corrected radio luminosity at 5 GHz (a proxy for jet power) and line width. When the Seyfert reflection features are fit with relativistically-blurred disk reflection models that measure spin, there is a tentative positive correlation between the Doppler-corrected radio luminosity and the spin measurement. Further, when we include stellar-mass black holes in the sample, to examine the effects across the mass scale, we find a slightly stronger correlation with radio luminosity per unit mass and spin, at a marginal significance (2.3 sigma confidence level). Finally, when we include neutron stars, in order to probe lower spin values, we find a positive correlation (3.3 sigma confidence level) between radio luminosity per unit mass and spin. Although tentative, these results suggest that spin may have a role in determining the jet luminosity. In addition, we find a slightly more significant correlation (4.4 sigma confidence level) between radio luminosity per Bolometric luminosity and spin, using our entire sample of black holes and neutrons stars. Again, although tentative, these relations point to the possibility that the mass accretion rate, i.e. Bolometric luminosity, is also important in determining the jet luminosity, in addition to spin. Our analysis suggests that mass accretion rate and disk or coronal magnetic field strength may be the "throttle" in these compact systems, to which the Eddington limit and spin may set the maximum jet luminosity that can be achieved.Comment: 14 pages, 13 Figures, ApJ Accepte

Evaluation of the personal health budget pilot programme

1. The personal health budget initiative is a key aspect of personalisation across health care services in England. Its aim is to improve patient outcomes, by placing patients at the centre of decisions about their care. Giving people greater choice and control, with patients working alongside health service professionals to develop and execute a care plan, given a known budget, is intended to encourage more responsiveness of the health and care system. 2. The personal health budget programme was launched by the Department of Health in 2009 after the publication of the 2008 Next Stage Review. An independent evaluation was commissioned alongside the pilot programme with the aim of identifying whether personal health budgets ensured better health and care outcomes when compared to conventional service delivery and, if so, the best way for personal health budgets to be implemented

Financial disincentives? A three-armed randomised controlled trial of the effect of financial Incentives in Diabetic Eye Assessment by Screening (IDEAS) trial

Objective Conflicting evidence exists regarding the impact of financial incentives on encouraging attendance at medical screening appointments. The primary aim was to determine whether financial incentives increase attendance at diabetic eye screening in persistent non-attenders. Methods and analysis A three-armed randomised controlled trial was conducted in London in 2015. 1051 participants aged over 16 years, who had not attended eye screening appointments for 2 years or more, were randomised (1.4:1:1 randomisation ratio) to receive the usual invitation letter (control), an offer of £10 cash for attending screening (fixed incentive) or a 1 in 100 chance of winning £1000 (lottery incentive) if they attend. The primary outcome was the proportion of invitees attending screening, and a comparative analysis was performed to assess group differences. Pairwise comparisons of attendance rates were performed, using a conservative Bonferroni correction for independent comparisons. Results 34/435 (7.8%) of control, 17/312 (5.5%) of fixed incentive and 10/304 (3.3%) of lottery incentive groups attended. Participants who received any incentive were significantly less likely to attend their appointment compared with controls (risk ratio (RR)=0.56; 95% CI 0.34 to 0.92). Those in the probabilistic incentive group (RR=0.42; 95% CI 0.18 to 0.98), but not the fixed incentive group (RR=1.66; 95% CI 0.65 to 4.21), were significantly less likely to attend than those in the control group. Conclusion Financial incentives, particularly lottery-based incentives, attract fewer patients to diabetic eye screening than standard invites in this population. Financial incentives should not be used to promote screening unless tested in context, as they may negatively affect attendance rates

Incentives in diabetic eye assessment by screening (IDEAS): study protocol of a three-arm randomized controlled trial using financial incentives to increase screening uptake in London

Background: Diabetes is an increasing public health problem in the UK and globally. Diabetic retinopathy is a microvascular complication of diabetes, and is one of the leading causes of blindness in the UK working age population. The diabetic eye screening programme in England aims to invite all people with diabetes aged 12 or over for retinal photography to screen for the presence of diabetic retinopathy. However, attendance rates are only 81 %, leaving many people at risk of preventable sight loss. Methods: This is a three arm randomized controlled trial to investigate the impact of different types of financial incentives (based on principles from behavioral economics) on increasing attendance at diabetic eye screening appointments in London. Eligible participants will be aged 16 or over, and are those who have been invited to screening appointments annually, but who have not attended, or telephoned to rearrange an appointment, within the last 24 months. Eligible participants will be randomized to one of three conditions: 1. Control condition (usual invitation letter) 2. Fixed incentive condition (usual invitation letter, including a voucher for £10 if they attend their appointment) 3. Probabilistic incentive condition (invitation letter, including a voucher for a 1 in 100 chance of winning £1000 if they attend their appointment). Participants will be sent invitation letters, and the primary outcome will be whether or not they attend their appointment. One thousand participants will be included in total, randomized with a ratio of 1.4:1:1. In order to test whether the incentive scheme has a differential impact on patients from different demographic or socio-economic groups, information will be recorded on age, gender, distance from screening center, socio-economic status and length of time since they were last screened. A cost-effectiveness analysis will also be performed. Discussion: This study will be the first trial of financial incentives for improving uptake of diabetic eye screening. If effective, the intervention may suggest a cost-effective way to increase screening rates, thus reducing unnecessary blindness

Tilted String Cosmologies

Global symmetries of the string effective action are employed to generate tilted, homogeneous Bianchi type VI_h string cosmologies from a previously known stiff perfect fluid solution to Einstein gravity. The dilaton field is not constant on the surfaces of homogeneity. The future asymptotic state of the models is interpreted as a plane wave and is itself an exact solution to the string equations of motion to all orders in the inverse string tension. An inhomogeneous generalization of the Bianchi type III model is also found.Comment: 9 pages, Standard Latex Source. To appear in Physics Letters B Minor change: Authors now alphabetically liste

Spectral and Timing Properties of IGR J17091-3624 in the Rising Hard State During its 2016 Outburst

We present a spectral and timing study of the NuSTAR and Swift observations of the black hole candidate IGR J17091-3624 in the hard state during its outburst in 2016. Disk reflection is detected in each of the NuSTAR spectra taken in three epochs. Fitting with relativistic reflection models reveals that the accretion disk is truncated during all epochs with $R_{\rm in}>10~r_{\rm g}$, with the data favoring a low disk inclination of $\sim 30^{\circ}-40^{\circ}$. The steepening of the continuum spectra between epochs is accompanied by a decrease in the high energy cut-off: the electron temperature $kT_{\rm e}$ drops from $\sim 64$ keV to $\sim 26$ keV, changing systematically with the source flux. We detect type-C QPOs in the power spectra with frequency varying between 0.131 Hz and 0.327 Hz. In addition, a secondary peak is found in the power spectra centered at about 2.3 times the QPO frequency during all three epochs. The nature of this secondary frequency is uncertain, however a non-harmonic origin is favored. We investigate the evolution of the timing and spectral properties during the rising phase of the outburst and discuss their physical implications.Comment: 11 pages, 9 figures, accepted by Ap