How to Undertake a Clinically Relevant Systematic Review in a Rapidly Evolving Field: Magnetic Resonance Angiography

Objectives: The aim was to determine which generations of the evolving technology of magnetic resonance angiography (MRA) are currently of clinical relevance in two clinical applications. Our purpose was to plan a systematic review that would be valuable both to purchasers driven by cost-effectiveness and to practicing clinicians. Methods: Information was gathered from a search of major bibliographic databases, from a short questionnaire sent to 500 U.K. vascular radiologists and vascular surgeons, and from local clinical The authors thank A. Jackson and all those who completed a questionnaire. This work was carried out with the financial support of the Secretary of State for Health under the NHS Health Technology Assessment Programme, project 97/13/04. The views and opinions expressed do not necessarily reflect those of the Secretary of State for Health. In part, this work was undertaken by the Leeds Teaching Hospitals NHS Trust, which received funding from the NHS Executive. The views expressed in this publication are those of the authors and not necessarily those of the NHS Executive.experts. We asked which of the MRA techniques were currently used and, assuming availability, what would be their technique of choice. Results: There were 206 published articles that satisfied preliminary inclusion criteria: 69 discussed 2D time of flight (TOF); 47, 3D TOF; and 38, contrast-enhanced techniques. There were 162 questionnaires returned (60 radiologists, 102 surgeons). Of the total respondents, 77/162 (48%) used MRA in the assessment of carotid artery stenosis; 47/77 (61%) used 2D TOF; 32/77 (42%), 3D TOF; and 26/77 (34%), contrast-enhanced techniques. Thirty-five of 162 (22%) respondents used MRA in the assessment of peripheral vascular disease (PVD); 15/35 (43%) used 2D TOF, 4/35 (11%) used 3D TOF, and 22/35 (63%) used contrast-enhanced techniques. For those wishing to use MRA, contrast-enhanced techniques were the method of choice. Conclusions: The TOF methods that represent earlier generations of the technology remain clinically relevant, and will therefore be included in our systematic review. To ensure complete and relevant coverage in reviews of other evolving technologies, it would be advisable to obtain data for guidance in a similar way

Use of magnetic resonance angiography to select candidates with recently symptomatic carotid stenosis for surgery: systematic review

Objective To determine if sufficient evidence exists to support the use of magnetic resonance angiography as a means of selecting patients with recently symptomatic high grade carotid stenosis for surgery. Design Systematic review of published research on the diagnostic performance of magnetic resonance angiography, 1990-9. Main outcome measures Performance characteristics of diagnostic test. Results 126 potentially relevant articles were identified, but many articles failed to examine die performance of magnetic resonance angiography as a diagnostic test at the surgical decision thresholds used in major clinical trials on endarterectomy. 26 articles were included in a meta-analysis that showed a maximal joint sensitivity and specificity of 99% (95% confidence interval 98% to 100%) for identifying 70-99% stenosis and 90% (81% to 99%) for identifying 50-99% stenosis. Only four articles evaluated contrast enhanced magnetic resonance angiography. Conclusions Magnetic resonance angiography is accurate for selecting patients for carotid endarterectomy at the surgical decision thresholds established in the major endarterectomy trials, but the evidence is not very robust because of the heterogeneity of the studies included. Research is to determine the diagnostic performance of the most recent developments in magnetic resonance angiography, including contrast enhanced techniques, as well as to assess the impact of magnetic resonance angiography on surgical decision making and outcomes

Two-dimensional Bose-Einstein Condensation in Cuprate Superconductors

Transition temperatures $T_{c}$ calculated using the BCS model electron-phonon interaction without any adjustable parameters agree with empirical values for quasi-2D cuprate superconductors. They follow from a two-dimensional gas of temperature-dependent Cooper pairs in chemical and thermal equilibrium with unpaired fermions in a boson-fermion (BF) statistical model as the Bose-Einstein condensation (BEC) singularity temperature is approached from above. The {\it linear} (as opposed to quadratic) boson dispersion relation due to the Fermi sea yields substantially higher $T_{c}$'s with the BF model than with BCS or pure-boson BEC theories.Comment: 7 pages including 2 figure

One-dimensional Cooper pairing

We study electron pairing in a one-dimensional (1D) fermion gas at zero temperature under zero- and finite-range, attractive, two-body interactions. The binding energy of Cooper pairs (CPs) with zero total or center-of-mass momentum (CMM) increases with attraction strength and decreases with interaction range for fixed strength. The excitation energy of 1D CPs with nonzero CMM display novel, unique properties. It satisfies a dispersion relation with \textit{two} branches: a\ phonon-like \textit{linear }excitation for small CP CMM; this is followed by roton-like \textit{quadratic} excitation minimum for CMM greater than twice the Fermi wavenumber, but only above a minimum threshold attraction strength. The expected quadratic-in-CMM dispersion \textit{in vacuo }when the Fermi wavenumber is set to zero is recovered for \textit{any% } coupling. This paper completes a three-part exploration initiated in 2D and continued in 3D.Comment: 12 pages, 6 figure

The BCS-Bose Crossover Theory

We contrast {\it four} distinct versions of the BCS-Bose statistical crossover theory according to the form assumed for the electron-number equation that accompanies the BCS gap equation. The four versions correspond to explicitly accounting for two-hole-(2h) as well as two-electron-(2e) Cooper pairs (CPs), or both in equal proportions, or only either kind. This follows from a recent generalization of the Bose-Einstein condensation (GBEC) statistical theory that includes not boson-boson interactions but rather 2e- and also (without loss of generality) 2h-CPs interacting with unpaired electrons and holes in a single-band model that is easily converted into a two-band model. The GBEC theory is essentially an extension of the Friedberg-T.D. Lee 1989 BEC theory of superconductors that excludes 2h-CPs. It can thus recover, when the numbers of 2h- and 2e-CPs in both BE-condensed and noncondensed states are separately equal, the BCS gap equation for all temperatures and couplings as well as the zero-temperature BCS (rigorous-upper-bound) condensation energy for all couplings. But ignoring either 2h- {\it or} 2e-CPs it can do neither. In particular, only {\it half} the BCS condensation energy is obtained in the two crossover versions ignoring either kind of CPs. We show how critical temperatures $T_{c}$ from the original BCS-Bose crossover theory in 2D require unphysically large couplings for the Cooper/BCS model interaction to differ significantly from the $T_{c}$s of ordinary BCS theory (where the number equation is substituted by the assumption that the chemical potential equals the Fermi energy).Comment: thirteen pages including two figures. Physica C (in press, 2007

Flood Suspended Sediment Transport: Combined Modelling from Dilute to Hyper-concentrated Flow

YesDuring flooding, the suspended sediment transport usually experiences a wide-range of dilute to hyper-concentrated suspended sediment transport depending on the local flow and ground con-ditions. This paper assesses the distribution of sediment for a variety of hyper-concentrated and dilute flows. Due to the differences between hyper-concentrated and dilute flows, a linear-power coupled model is proposed to integrate these considerations. A parameterised method combining the sediment size, Rouse number, mean concentration, and flow depth parameters has been used for modelling the sediment profile. The accuracy of the proposed model has been verified against the reported laboratory measurements and comparison with other published analytical methods. The proposed method has been shown to effectively compute the concentration profile for a wide range of suspended sediment conditions from hyper-concentrated to dilute flows. Detailed com-parisons reveal that the proposed model calculates the dilute profile with good correspondence to the measured data and other modelling results from literature. For the hyper-concentrated profile, a clear division of lower (bed-load) to upper layer (suspended-load) transport can be observed in the measured data. Using the proposed model, the transitional point from this lower to upper layer transport can be calculated precisely

A Comparison of Solar Cycle Variations in the Equatorial Rotation Rates of the Sun's Subsurface, Surface, Corona, and Sunspot Groups

Using the Solar Optical Observing Network (SOON) sunspot-group data for the period 1985-2010, the variations in the annual mean equatorial-rotation rates of the sunspot groups are determined and compared with the known variations in the solar equatorial-rotation rates determined from the following data: i) the plasma rotation rates at 0.94Rsun, 0.95Rsun,...,1.0Rsun measured by Global Oscillation Network Group (GONG) during the period 1995-2010, ii) the data on the soft X-ray corona determined from Yohkoh/SXT full disk images for the years 1992-2001, iii) the data on small bright coronal structures (SBCS) which were traced in Solar and Heliospheric Observatory (SOHO)/EIT images during the period 1998-2006, and iv) the Mount Wilson Doppler-velocity measurements during the period 1986-2007. A large portion (up to approximate 30 deg latitude) of the mean differential-rotation profile of the sunspot groups lies between those of the internal differential-rotation rates at 0.94Rsun and 0.98Rsun.The variation in the yearly mean equatorial-rotation rate of the sunspot groups seems to be lagging that of the equatorial-rotation rate determined from the GONG measurements by one to two years.The amplitude of the latter is very small.The solar-cycle variation in the equatorial-rotation rate of the solar corona closely matches that determined from the sunspot-group data.The variation in the equatorial-rotation rate determined from the Mount Wilson Doppler-velocity data closely resembles the corresponding variation in the equatorial-rotation rate determined from the sunspot-group data that included the values of the abnormal angular motions (> 3 deg per day) of the sunspot groups. Implications of these results are pointed out.Comment: 22 pages, 10 figures, accepted by Solar Physic

Mosquito Net Use in an Artisanal East African Fishery

Widespread, anecdotal reports of the use of bed nets designed for malaria control (“mosquito nets”) in artisanal fisheries have led to concern from health and natural resource management sectors. However, mosquito net fishing (MNF) may play an important role in the livelihoods of artisanal fishers, an aspect not yet investigated. At a coastal Kenyan site among Giriama fishers, nearly half of homesteads interviewed used mosquito nets as fishing gear, targeting juvenile fish and prawns for subsistence and sale. The majority of mosquito net (MN) fishers here were men, suggesting that the assumption that MNF is a female activity is not valid in this case. However, MN use for fishing at this site is unlikely to impact malaria protection as fishers used old or surplus nets. Respondents perceived both positive aspects of MNF (e.g., food and income) and negative aspects (e.g., impact on fishery). As mosquito nets are widely available, they may enable new entrants to access fisheries. There is a critical need to review current management responses, which predominately focus on banning the practice, and instead promote integrated strategies for sustainable livelihoods

The use of sewage treatment works as foraging sites by insectivorous bats

Sewage treatment works with percolating filter beds are known to provide profitable foraging areas for insectivorous birds due to their association with high macroinvertebrate densities. Fly larvae developing on filter beds at sewage treatment works may similarly provide a valuable resource for foraging bats. Over the last two decades, however, there has been a decline in filter beds towards a system of “activated sludge”. Insects and bat activity were surveyed at 30 sites in Scotland employing these two different types of sewage treatment in order to assess the possible implications of these changes for foraging bats. Bat activity (number of passes) recorded from broad-band bat detectors was quantified at three points within each site. The biomass of aerial insects, sampled over the same period as the detector surveys, was measured using a suction trap. The biomass of insects and activity of Pipistrellus spp. was significantly higher at filter beds than at activated sludge sites. In addition, whilst foraging activity of Pipistrellus spp. at filter beds was comparable to that of adjacent “good” foraging habitat, foraging at activated sludge sites was considerably lower. This study indicates the high potential value of an anthropogenic process to foraging bats, particularly in a landscape where their insect prey has undergone a marked decline, and suggests that the current preference for activated sludge systems is likely to reduce the value of treatment works as foraging sites for bats