Developing and evaluating interventions to reduce inappropriate prescribing by general practitioners of antibiotics for upper respiratory tract infections: a randomised controlled trial to compare paper-based and web-based modelling experiments

Background: Much implementation research is focused on full-scale trials with little evidence of preceding modelling work. The Medical Research Council Framework for developing and evaluating complex interventions has argued for more and better theoretical and exploratory work prior to a trial as a means of improving intervention development. Intervention modelling experiments (IMEs) are a way of exploring and refining an intervention before moving to a full-scale trial. They do this by delivering key elements of the intervention in a simulation that approximates clinical practice by, for example, presenting general practitioners (GPs) with a clinical scenario about making a treatment decision. Methods: The current proposal will run a full, web-based IME involving 250 GPs that will advance the methodology of IMEs by directly comparing results with an earlier paper-based IME. Moreover, the web-based IME will evaluate an intervention that can be put into a full-scale trial that aims to reduce antibiotic prescribing for upper respiratory tract infections in primary care. The study will also include a trial of email versus postal invitations to participate. Discussion: More effective behaviour change interventions are needed and this study will develop one such intervention and a system to model and test future interventions. This system will be applicable to any situation in the National Health Service where behaviour needs to be modified, including interventions aimed directly at the public. Trial registration: ClinicalTrials (NCT): NCT0120673

The Distribution of Lya-Emitting Galaxies at z=2.3

We present the detection of 34 Ly-alpha emission-line galaxy candidates in a 80x80x60 co-moving Mpc region surrounding the known z=2.38 galaxy cluster J2143-4423. The space density of Ly-alpha emitters is comparable to that found by Steidel et al. when targeting a cluster at redshift 3.09, but is a factor of 5.8 +/- 2.5 greater than that found by field samples at similar redshifts. The distribution of these galaxy candidates contains several 5-10 Mpc scale voids. We compare our observations with mock catalogs derived from the VIRGO consortium Lambda-CDM n-body simulations. Fewer than 1% of the mock catalogues contain voids as large as we observe. Our observations thus tentatively suggest that the galaxy distribution at redshift 2.38 contains larger voids than predicted by current models. Three of the candidate galaxies and one previously discovered galaxy have the large luminosities and extended morphologies of "Ly-alpha blobs".Comment: 10 pages, 8 figures, emulateapj5, Accepted for publication in Ap

Mars simulated exposure and the characteristic Raman biosignatures of amino acids and halophilic microbes

Though Raman bands of α-amino acids (AA) are well documented, often only the strongest intensity bands are quoted as identifiers (e.g. Jenkins et al., 2005; De Gelder et al., 2007; Zhu et al., 2011). Unknown regolith mixtures on Mars-sampling missions could obscure these bands. Here the case is made for determining, via a statistical method, sets of characteristic bands to be used as identifiers, independent of band intensity or number of bands (Rolfe et al., 2016). AA have upwards of 25 potentially identifying bands and this method defines sets of 10–19 bands per AA. Examination of AA-doped Mars-like basalt resulted in a maximum of eight bands being identified, as some characteristic bands were obscured by mineral bands, including the strongest intensity band in some cases. This proved the need for characteristic bands to be defined, enabling successful identification of AA. The ESA ExoMars Rover mission will crush and then pass the sample to the Raman Laser Spectrometer. We crushed a Mars-like basalt to a similar grain size expected to be created by the rover. Our samples were doped with 1 % (by weight) AA samples, resulting in no detection of AA, because of loss of original spatial context and spaces between the grains. We recommend that Raman spectroscopy on future missions should be conducted before the sample is crushed. Halite-entombed halophilic microbes, known to survive being entombed, were exposed to Mars-like surface (including temperature, pressure, atmospheric composition and UV) and freeze-thaw cycle (plus pressure and atmospheric composition) conditions. This test on the survival of the microbes showed that survival rates quickly deteriorated in surface conditions, but freeze-thaw cycle samples had well preserved Raman biosignatures, indicating that similar signatures could be detectable on Mars if similar life persists in evaporitic material or brines today

Work-related psychological health and psychological type among lead elders within the Newfrontiers network of churches in the United Kingdom

Building on a series of recent studies concerned with assessing work-related psychological health and psychological type among various groups of church leaders, this study reports new data provided by 134 Lead Elders within the Newfrontiers network of churches in the United Kingdom who completed the Francis Psychological Type Scales (FPTS) together with the two scales of the Francis Burnout Inventory (FBI) concerned with emotional exhaustion and satisfaction in ministry. Compared with other groups of church leaders, Lead Elders within the Newfrontiers network of churches reported lower levels of emotional exhaustion and higher levels of satisfaction in ministry. Compared with other groups of church leaders, there was a higher proportion of extraverts among Lead Elders within the Newfrontiers network of churches. There was only a weak association between psychological type and burnout

In vivo imaging of cellular proliferation in colorectal cancer using positron emission tomography

Background and aims: Positron emission tomography (PET) using 18F labelled 2-fluoro-2-deoxy-D-glucose (18FDG) is an established imaging tool, although the recent development of a biologically stable thymidine analogue [18F] 3'-deoxy-3-fluorothymidine (18FLT) has allowed PET to image cellular proliferation by utilising the salvage pathway of DNA synthesis. In this study, we have compared uptake of 18FLT and 18FDG with MIB-1 immunohistochemistry to evaluate the role of PET in quantifying in vivo cellular proliferation in colorectal cancer (CRC). Patients and methods: Patients with resectable, primary, or recurrent CRC were prospectively studied. Thirteen lesions from 10 patients (five males, five females), median age 68 years (range 54–87), were evaluated. Patients underwent 18FDG and 18FLT PET scanning. Tracer uptake within lesions was quantified using standardised uptake values (SUVs). Histopathological examination and MIB-1 immunohistochemistry were performed on all lesions, and proliferation quantified by calculating a labelling index (% of MIB-1 positively stained nuclei within 1500 tumour cells). Results: Histology confirmed adenocarcinoma in 12 of 13 lesions; the remaining lesion was reactive. All eight extrahepatic lesions were visualised using both 18FLT and 18FDG. Three of the five resected liver metastases were also avid for 18FLT and showed high proliferation, while the remaining two lesions which demonstrated no uptake of 18FLT had correspondingly very low proliferation. There was a statistically significant positive correlation (r =0.8, p<0.01) between SUVs of the tumours visualised with 18FLT and the corresponding MIB-1 labelling indices. No such correlation was demonstrated with 18FDG avid lesions (r =0.4). Conclusions: 18FLT PET correlates with cellular proliferation markers in both primary and metastatic CRC. This technique could provide a mechanism for in vivo grading of malignancy and early prediction of response to adjuvant chemotherapy

EPG-representations with small grid-size

In an EPG-representation of a graph $G$ each vertex is represented by a path in the rectangular grid, and $(v,w)$ is an edge in $G$ if and only if the paths representing $v$ an $w$ share a grid-edge. Requiring paths representing edges to be x-monotone or, even stronger, both x- and y-monotone gives rise to three natural variants of EPG-representations, one where edges have no monotonicity requirements and two with the aforementioned monotonicity requirements. The focus of this paper is understanding how small a grid can be achieved for such EPG-representations with respect to various graph parameters. We show that there are $m$-edge graphs that require a grid of area $\Omega(m)$ in any variant of EPG-representations. Similarly there are pathwidth-$k$ graphs that require height $\Omega(k)$ and area $\Omega(kn)$ in any variant of EPG-representations. We prove a matching upper bound of $O(kn)$ area for all pathwidth-$k$ graphs in the strongest model, the one where edges are required to be both x- and y-monotone. Thus in this strongest model, the result implies, for example, $O(n)$, $O(n \log n)$ and $O(n^{3/2})$ area bounds for bounded pathwidth graphs, bounded treewidth graphs and all classes of graphs that exclude a fixed minor, respectively. For the model with no restrictions on the monotonicity of the edges, stronger results can be achieved for some graph classes, for example an $O(n)$ area bound for bounded treewidth graphs and $O(n \log^2 n)$ bound for graphs of bounded genus.Comment: Appears in the Proceedings of the 25th International Symposium on Graph Drawing and Network Visualization (GD 2017

Slotted Rotatable Target Assembley and Systematic Error Analysis for a Search for Long Range Spin Dependent Interactions from Exotic Vector Boson Exchange Using Neutron Spin Rotation

We discuss the design and construction of a novel target array of nonmagnetic test masses used in a neutron polarimetry measurement made in search for new possible exotic spin dependent neutron–atominteractions of Nature at sub-mm length scales. This target was designed to accept and efficiently transmit a transversely polarized slow neutron beam through a series of long open parallel slots bounded by flat rectangular plates. These openings possessed equal atom density gradients normal to the slots from the flat test masses with dimensions optimized to achieve maximum sensitivity to an exotic spin-dependent interaction from vector boson exchanges with ranges in the mm - μm regime. The parallel slots were oriented differently in four quadrants that can be rotated about the neutron beam axis in discrete 90°increments using a Geneva drive. The spin rotation signals from the 4 quadrants were measured using a segmented neutron ion chamber to suppress possible systematic errors from stray magnetic fields in the target region. We discuss the per-neutron sensitivity of the target to the exotic interaction, the design constraints, the potential sources of systematic errors which could be present in this design, and our estimate of the achievable sensitivity using this method

Analisa Kestabilan Model Penyebaran Penyakit Rabies

Rabies is a dangerous disease that can cause death due to rabies virus attacks the spinal cord of the infected and can cause paralysis. But if it enters the limbic system or midbrain, it will cause aggression and loss of sense. The widespread dissemination of this disease is growth increasingly. This research will discuss about the model of the spread rabies and then analyze stability of this model by using simple epidemiological model to determine the initial equilibrium point and eigenvalues, which would be analyzed the stability of this model. This model has two main variables and , where is the susceptible and is the infectives. This research found the stability model at ( ) equilibrium point with the value of parameter is √