864 research outputs found
Higher Structures in M-Theory
The key open problem of string theory remains its non-perturbative completion
to M-theory. A decisive hint to its inner workings comes from numerous
appearances of higher structures in the limits of M-theory that are already
understood, such as higher degree flux fields and their dualities, or the
higher algebraic structures governing closed string field theory. These are all
controlled by the higher homotopy theory of derived categories, generalised
cohomology theories, and -algebras. This is the introductory chapter
to the proceedings of the LMS/EPSRC Durham Symposium on Higher Structures in
M-Theory. We first review higher structures as well as their motivation in
string theory and beyond. Then we list the contributions in this volume,
putting them into context.Comment: 22 pages, Introductory Article to Proceedings of LMS/EPSRC Durham
Symposium Higher Structures in M-Theory, August 2018, references update
Diabetes and lipid screening among patients in primary care: A cohort study
<p>Abstract</p> <p>Background</p> <p>Obesity is associated with increased cardiovascular diseases and diabetes mellitus. Guidelines call for intensified glucose and lipid screening among overweight and obese patients. Data on compliance with these guidelines are scarce. The purpose of this study was to assess rates of diabetes and lipid screening in primary care according to demographic variables and weight status.</p> <p>Methods</p> <p>Over a 3-year follow-up period, we assessed screening rates for blood glucose, triglycerides, and HDL- and LDL-cholesterol among 5025 patients in primary care. From proportional hazards models we estimated screening rates among low, moderate, high, and very-high risk patients and compared them with recommendations of the American Diabetes Association (ADA), National Cholesterol Education Program (ATP III) and U.S. Preventive Services Task Force (USPSTF).</p> <p>Results</p> <p>Mean (SD) age was 47.4 (15.6); 69% were female, 21% were non-white, and 30% of males and 25% of females were obese (BMI ≥ 30 kg/m<sup>2</sup>). For both diabetes and lipid screening, the adjusted hazard was 260–330% higher among ≥65 than <35 year-olds, 50–90% higher in persons with BMI ≥ 35 than <25 kg/m<sup>2</sup>, 10–30% lower for females than males, and not lower among racial/ethnic minorities. Screening rates were at least 80% among very-high risk persons, which we defined as 55–64 years old, BMI ≥ 35 kg/m<sup>2</sup>, non-white, with baseline hypertension. In contrast, high-risk persons who were younger (35–44 years old) and less obese (BMI 30–<35 kg/m<sup>2</sup>) were screened less often (43% for LDL-cholesterol among females to 83% for diabetes among males) even though ADA, ATP III and USPSTF recommend diabetes and lipid screening among them.</p> <p>Conclusion</p> <p>Patients with higher BMI or age were more likely to be screened for cardiometabolic risk factors. Women were screened at lower rates than men. Even in a highly structured medical group practice, some obese patients were under-screened for diabetes and dyslipidemia.</p
Resolved Inner Disks around Herbig Ae/Be Stars
We have observed 14 Herbig Ae/Be sources with the long-baseline near-IR
Palomar Testbed Interferometer, All except two sources are resolved at 2.2 um,
with angular sizes generally <5 mas. We determine the size scales and
orientations of the 2.2 um emission using various models: uniform disks,
Gaussians, uniform rings, flat accretion disks with inner holes, and flared
disks with puffed-up inner rims; 7 objects display significantly inclined
morphologies, generally compatible with the outer disk geometries inferred from
millimeter interferometric observations, implying that HAEBE disks are not
significantly warped. Using the derived inner disk sizes and inclinations, we
compute the spectral energy distributions for two simple physical disk models,
and compare these with observed SEDs compiled from the literature and new
near-IR photometry. While geometrically flat accretion disk models are
consistent with the data for the earliest spectral types in our sample (MWC
297, V1685 Cyg, and MWC 1080), the later-type sources are explained better
through models incorporating puffed-up inner disk walls; this may indicate
different accretion mechanisms for early and late-type Herbig Ae/Be stars.Comment: 54 pages, including 16 figures. Accepted for publication in the
Astrophysical Journal (October 2004 issue
The relationships between golf and health:A scoping review
OBJECTIVE: To assess the relationships between golf and health. DESIGN: Scoping review. DATA SOURCES: Published and unpublished reports of any age or language, identified by searching electronic databases, platforms, reference lists, websites and from consulting experts. REVIEW METHODS: A 3-step search strategy identified relevant published primary and secondary studies as well as grey literature. Identified studies were screened for final inclusion. Data were extracted using a standardised tool, to form (1) a descriptive analysis and (2) a thematic summary. RESULTS AND DISCUSSION: 4944 records were identified with an initial search. 301 studies met criteria for the scoping review. Golf can provide moderate intensity physical activity and is associated with physical health benefits that include improved cardiovascular, respiratory and metabolic profiles, and improved wellness. There is limited evidence related to golf and mental health. The incidence of golfing injury is moderate, with back injuries the most frequent. Accidental head injuries are rare, but can have serious consequences. CONCLUSIONS: Practitioners and policymakers can be encouraged to support more people to play golf, due to associated improved physical health and mental well-being, and a potential contribution to increased life expectancy. Injuries and illnesses associated with golf have been identified, and risk reduction strategies are warranted. Further research priorities include systematic reviews to further explore the cause and effect nature of the relationships described. Research characterising golf's contribution to muscular strengthening, balance and falls prevention as well as further assessing the associations and effects between golf and mental health are also indicated
The JCMT Transient Survey: Stochastic and Secular Variability of Protostars and Disks In the Submillimeter Region Observed over 18 Months
This is the final version of the article. Available from American Astronomical Society via the DOI in this record.We analyze results from the first 18 months of monthly submillimeter monitoring of eight star-forming regions in the JCMT Transient Survey. In our search for stochastic variability in 1643 bright peaks, only the previously identified source, EC 53, shows behavior well above the expected measurement uncertainty. Another four sources—two disks and two protostars—show moderately enhanced standard deviations in brightness, as expected for stochastic variables. For the two protostars, this apparent variability is the result of single epochs that are much brighter than the mean. In our search for secular brightness variations that are linear in time, we measure the fractional brightness change per year for 150 bright peaks, 50 of which are protostellar. The ensemble distribution of slopes is well fit by a normal distribution with σ ~ 0.023. Most sources are not rapidly brightening or fading at submillimeter wavelengths. Comparison against time-randomized realizations shows that the width of the distribution is dominated by the uncertainty in the individual brightness measurements of the sources. A toy model for secular variability reveals that an underlying Gaussian distribution of linear fractional brightness change σ = 0.005 would be unobservable in the present sample, whereas an underlying distribution with σ = 0.02 is ruled out. Five protostellar sources, 10% of the protostellar sample, are found to have robust secular measures deviating from a constant flux. The sensitivity to secular brightness variations will improve significantly with a sample over a longer time duration, with an improvement by factor of two expected by the conclusion of our 36 month survey.The JCMT is operated by the East Asian Observatory on behalf of The National Astronomical Observatory of Japan, Academia Sinica Institute of Astronomy and Astrophysics, the Korea Astronomy and Space Science Institute, the National Astronomical Observatories of China and the Chinese Academy of Sciences (Grant No. XDB09000000), with additional funding support from the Science and Technology Facilities Council of the United Kingdom and participating universities in the United Kingdom and Canada. The identification number for the JCMT Transient Survey under which the SCUBA-2 data used in this paper can be found is M16AL001.
The authors thank the JCMT staff for their support of the GBS team in data collection and reduction efforts. The Starlink software (Currie et al. 2014) is supported by the East Asian Observatory.
This research has made use of NASA's Astrophysics Data System and the facilities of the Canadian Astronomy Data Centre operated by the National Research Council of Canada with the support of the Canadian Space Agency. This research used the services of the Canadian Advanced Network for Astronomy Research (CANFAR), which in turn is supported by CANARIE, Compute Canada, University of Victoria, the National Research Council of Canada, and the Canadian Space Agency
27th Annual Midwest/Midsouth Estate Planning Institute
Materials from the 27th Annual Midwest/Midsouth Estate Planning Institute held by UK/CLE in July 2000
Artificial drainage of peatlands: hydrological and hydrochemical process and wetland restoration
Peatlands have been subject to artificial drainage for centuries. This drainage has been in response to agricultural demand, forestry, horticultural and energy properties of peat and alleviation of flood risk. However, the are several environmental problems associated with drainage of peatlands. This paper describes the nature of these problems and examines the evidence for changes in hydrological and hydrochemical processes associated with these changes. Traditional black-box water balance approaches demonstrate little about wetland dynamics and therefore the science of catchment response to peat drainage is poorly understood. It is crucial that a more process-based approach be adopted within peatland ecosystems. The environmental problems associated with peat drainage have led, in part, to a recent reversal in attitudes to peatlands and we have seen a move towards wetland restoration. However, a detailed understanding of hydrological, hydrochemical and ecological process-interactions will be fundamental if we are to adequately restore degraded peatlands, preserve those that are still intact and understand the impacts of such management actions at the catchment scale
Multi-centre parallel arm randomised controlled trial to assess the effectiveness and cost-effectiveness of a group-based cognitive behavioural approach to managing fatigue in people with multiple sclerosis
Abstract (provisional)
Background
Fatigue is one of the most commonly reported and debilitating symptoms of multiple sclerosis (MS); approximately two-thirds of people with MS consider it to be one of their three most troubling symptoms. It may limit or prevent participation in everyday activities, work, leisure, and social pursuits, reduce psychological well-being and is one of the key precipitants of early retirement. Energy effectiveness approaches have been shown to be effective in reducing MS-fatigue, increasing self-efficacy and improving quality of life. Cognitive behavioural approaches have been found to be effective for managing fatigue in other conditions, such as chronic fatigue syndrome, and more recently, in MS. The aim of this pragmatic trial is to evaluate the clinical and cost-effectiveness of a recently developed group-based fatigue management intervention (that blends cognitive behavioural and energy effectiveness approaches) compared with current local practice.
Methods
This is a multi-centre parallel arm block-randomised controlled trial (RCT) of a six session group-based fatigue management intervention, delivered by health professionals, compared with current local practice. 180 consenting adults with a confirmed diagnosis of MS and significant fatigue levels, recruited via secondary/primary care or newsletters/websites, will be randomised to receive the fatigue management intervention or current local practice. An economic evaluation will be undertaken alongside the trial. Primary outcomes are fatigue severity, self-efficacy and disease-specific quality of life. Secondary outcomes include fatigue impact, general quality of life, mood, activity patterns, and cost-effectiveness. Outcomes in those receiving the fatigue management intervention will be measured 1 week prior to, and 1, 4, and 12 months after the intervention (and at equivalent times in those receiving current local practice). A qualitative component will examine what aspects of the fatigue management intervention participants found helpful/unhelpful and barriers to change.
Discussion
This trial is the fourth stage of a research programme that has followed the Medical Research Council guidance for developing and evaluating complex interventions. What makes the intervention unique is that it blends cognitive behavioural and energy effectiveness approaches. A potential strength of the intervention is that it could be integrated into existing service delivery models as it has been designed to be delivered by staff already working with people with MS. Service users will be involved throughout this research. Trial registration: Current Controlled Trials ISRCTN7651747
PYTHIA 6.4 Physics and Manual
The PYTHIA program can be used to generate high-energy-physics `events', i.e.
sets of outgoing particles produced in the interactions between two incoming
particles. The objective is to provide as accurate as possible a representation
of event properties in a wide range of reactions, within and beyond the
Standard Model, with emphasis on those where strong interactions play a role,
directly or indirectly, and therefore multihadronic final states are produced.
The physics is then not understood well enough to give an exact description;
instead the program has to be based on a combination of analytical results and
various QCD-based models. This physics input is summarized here, for areas such
as hard subprocesses, initial- and final-state parton showers, underlying
events and beam remnants, fragmentation and decays, and much more. Furthermore,
extensive information is provided on all program elements: subroutines and
functions, switches and parameters, and particle and process data. This should
allow the user to tailor the generation task to the topics of interest.Comment: 576 pages, no figures, uses JHEP3.cls. The code and further
information may be found on the PYTHIA web page:
http://www.thep.lu.se/~torbjorn/Pythia.html Changes in version 2: Mistakenly
deleted section heading for "Physics Processes" reinserted, affecting section
numbering. Minor updates to take into account referee comments and new colour
reconnection option
GP/GPN partner* perspectives on clinical placements for student nurses in general practice: can a community of practice help to change the prevailing culture within general practice?
Background: The UK Government document 5 year forward view describes the need to move chronic disease management from secondary to primary care, which will require a significant increase in the numbers of General Practice Nurses (GPNs). Until recently, there has been no specific recruitment strategy to address this increased need. In recent times, a number of solutions have been suggested to address this impending GPN recruitment crisis. For example, Health Education England (HEE) commission General Practitioners (GPs), who are members of the Advanced Training Practice Scheme (ATPS), to provide placements for student nurses within general practice. Methods: A descriptive qualitative study was undertaken, in which data were collected using semi-structured interviews with 16 GPs and 2 GPN partners∗. Qualitative analysis used a framework approach and themes were cross-checked within the team and member checking was undertaken with a convenience sample of GPs. The research had ethical approval and anonymity and confidentiality were maintained. Results: From the GP perspective, there were two key themes that emerged from the data. The first theme of 'fishing in the same small pond' included succession planning for the general practice workforce, the 'merry go round' of poaching staff from other practices, and the myths and misunderstandings that have grown up around general practice nursing. The second theme, 'growing your own', looked at the impact of the student nurse placements as a means to address the crisis in GPN recruitment. There was recognition of the need for cultural change in the way that GPNs are recruited, and that the ATPS was one way of helping to achieve that change. There were however a number of challenges to sustaining this cultural shift, such as the financial constrains placed upon the GP practice, and the need to function as a 'small business'. Conclusions: Despite all the challenges, the evidence is that, through the Community of Practice (CoP), the ATPS scheme is beginning to 'bear fruit', and there is a subtle but discernible move by GPs from a 'why would we?' to 'why wouldn't we?' invest in education and training for nurses in general practice. N.B. The term GPN partner∗denotes a GPN who is a 'full partner' in the practice business, holding the same NHS contracts and the same status as a GP. For the purposes of the paper itself, the term GP will be used to denote both types of partner
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