Constraints on Automorphic Forms of Higher Derivative Terms from Compactification

By dimensionally reducing the higher derivative corrections of ten-dimensional IIB theory on a torus we deduce constraints on the E_{n+1} automorphic forms that occur in d=10-n dimensions. In particular we argue that these automorphic forms involve the representation of E_{n+1} with fundamental weight \lambda^{n+1}, which is also the representation to which the string charges in d dimensions belong. We also consider a similar calculation for the reduction of higher derivative terms in eleven-dimensional M-theory.Comment: Minor corrections, to appear in JHE

Higher derivative type II string effective actions, automorphic forms and E11

By dimensionally reducing the ten-dimensional higher derivative type IIA string theory effective action we place constraints on the automorphic forms that appear in the effective action in lower dimensions. We propose a number of properties of such automorphic forms and consider the prospects that E11 can play a role in the formulation of the higher derivative string theory effective action.Comment: 34 page

Agriculture's prominence in the INDCs

Analysis of agriculture in countries’ climate change mitigation and adaptation strategies finds: Most Parties to the UNFCCC include agriculture in their mitigation targets (80%) and adaptation strategies (64%); Non-annex 1 Parties note the need for international financial support to implement their INDCs and raise the ambition of their contributions; For countries to meet their targets, climate finance will need to address agriculture

How countries plan to address agricultural adaptation and mitigation

Agriculture is well represented in Parties’ adaptation and mitigation strategies as communicated in their Intended Nationally Determined Contributions (INDCs) to the United Nations Framework Convention on Climate Change (UNFCCC). There is much attention to conventional agricultural practices that can be climate-smart (e.g. livestock and crop management), but less to the enabling services that can facilitate uptake (e.g. climate information services, insurance, and credit). Considerable finance is needed for agricultural adaptation and mitigation by Least Developed Countries (LDCs) – in the order of USD 3 billion annually for adaptation and 2 billion annually for mitigation. Parties need better information in order to refine their finance needs. Non-Annex 1 Parties raise issues of climate justice, social inequality and food security in their INDCs

Design choices made by target users for a pay-for-performance program in primary care: an action research approach

Contains fulltext : 110832.pdf (publisher's version ) (Open Access)BACKGROUND: International interest in pay-for-performance (P4P) initiatives to improve quality of health care is growing. Current programs vary in the methods of performance measurement, appraisal and reimbursement. One may assume that involvement of health care professionals in the goal setting and methods of quality measurement and subsequent payment schemes may enhance their commitment to and motivation for P4P programs and therefore the impact of these programs. We developed a P4P program in which the target users were involved in decisions about the P4P methods. METHODS: For the development of the P4P program a framework was used which distinguished three main components: performance measurement, appraisal and reimbursement. Based on this framework design choices were discussed in two panels of target users using an adapted Delphi procedure. The target users were 65 general practices and two health insurance companies in the South of the Netherlands. RESULTS: Performance measurement was linked to the Dutch accreditation program based on three domains (clinical care, practice management and patient experience). The general practice was chosen as unit of assessment. Relative standards were set at the 25th percentile of group performance. The incentive for clinical care was set twice as high as the one for practice management and patient experience. Quality scores were to be calculated separately for all three domains, and for both the quality level and the improvement of performance. The incentive for quality level was set thrice as high as the one for the improvement of performance. For reimbursement, quality scores were divided into seven levels. A practice with a quality score in the lowest group was not supposed to receive a bonus. The additional payment grew proportionally for each extra group. The bonus aimed at was on average 5% to 10% of the practice income. CONCLUSIONS: Designing a P4P program for primary care with involvement of the target users gave us an insight into their motives, which can help others who need to discuss similar programs. The resulting program is in line with target users' views and assessments of relevance and applicability. This may enhance their commitment to the program as was indicated by the growing number of voluntary participants after a successfully performed field test during the procedure. The elements of our framework can be very helpful for others who are developing or evaluating a P4P program

Meaning behind measurement : self-comparisons affect responses to health related quality of life questionnaires

Purpose The subjective nature of quality of life is particularly pertinent to the domain of health-related quality of life (HRQOL) research. The extent to which participants’ responses are affected by subjective information and personal reference frames is unknown. This study investigated how an elderly population living with a chronic metabolic bone disorder evaluated self-reported quality of life. Methods Participants (n = 1,331) in a multi-centre randomised controlled trial for the treatment of Paget’s disease completed annual HRQOL questionnaires, including the SF-36, EQ-5D and HAQ. Supplementary questions were added to reveal implicit reference frames used when making HRQOL evaluations. Twenty-one participants (11 male, 10 female, aged 59–91 years) were interviewed retrospectively about their responses to the supplementary questions, using cognitive interviewing techniques and semi-structured topic guides. Results The interviews revealed that participants used complex and interconnected reference frames to promote response shift when making quality of life evaluations. The choice of reference frame often reflected external factors unrelated to individual health. Many participants also stated that they were unclear whether to report general or disease-related HRQOL. Conclusions It is important, especially in clinical trials, to provide instructions clarifying whether ‘quality of life’ refers to disease-related HRQOL. Information on selfcomparison reference frames is necessary for the interpretation of responses to questions about HRQOL.The Chief Scientist Office of the Scottish Government Health Directorates, The PRISM funding bodies (the Arthritis Research Campaign, the National Association for the Relief of Paget’s disease and the Alliance for Better Bone Health)Peer reviewedAuthor final versio

A cluster randomized trial to assess the impact of clinical pathways for patients with stroke: rationale and design of the Clinical Pathways for Effective and Appropriate Care Study [NCT00673491]

<p>Abstract</p> <p>Background</p> <p>Patients with stroke should have access to a continuum of care from organized stroke units in the acute phase, to appropriate rehabilitation and secondary prevention measures. Moreover to improve the outcomes for acute stroke patients from an organizational perspective, the use of multidisciplinary teams and the delivery of continuous stroke education both to the professionals and to the public, and the implementation of evidence-based stroke care are recommended. Clinical pathways are complex interventions that can be used for this purpose. However in stroke care the use of clinical pathways remains questionable because little prospective controlled data has demonstrated their effectiveness. The purpose of this study is to determine whether clinical pathways could improve the quality of the care provided to the patients affected by stroke in hospital and through the continuum of the care.</p> <p>Methods</p> <p>Two-arm, cluster-randomized trial with hospitals and rehabilitation long-term care facilities as randomization units. 14 units will be randomized either to arm 1 (clinical pathway) or to arm 2 (no intervention, usual care). The sample will include 238 in each group, this gives a power of 80%, at 5% significance level. The primary outcome measure is 30-days mortality. The impact of the clinical pathways along the continuum of care will also be analyzed by comparing the length of hospital stay, the hospital re-admissions rates, the institutionalization rates after hospital discharge, the patients' dependency levels, and complication rates. The quality of the care provided to the patients will be assessed by monitoring the use of diagnostic and therapeutic procedures during hospital stay and rehabilitation, and by the use of key quality indicators at discharge. The implementation of organized care will be also evaluated.</p> <p>Conclusion</p> <p>The management of patients affected by stroke involves the expertise of several professionals, which can result in poor coordination or inefficiencies in patient treatment, and clinical pathways can significantly improve the outcomes of these patients. It is proposed that this study will test a new hypothesis and provide evidence of how clinical pathways can work.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov ID [NCT00673491]</p

Geogenetic patterns in mouse lemurs (genus Microcebus) reveal the ghosts of Madagascar's forests past.

Phylogeographic analysis can be described as the study of the geological and climatological processes that have produced contemporary geographic distributions of populations and species. Here, we attempt to understand how the dynamic process of landscape change on Madagascar has shaped the distribution of a targeted clade of mouse lemurs (genus Microcebus) and, conversely, how phylogenetic and population genetic patterns in these small primates can reciprocally advance our understanding of Madagascar's prehuman environment. The degree to which human activity has impacted the natural plant communities of Madagascar is of critical and enduring interest. Today, the eastern rainforests are separated from the dry deciduous forests of the west by a large expanse of presumed anthropogenic grassland savanna, dominated by the Family Poaceae, that blankets most of the Central Highlands. Although there is firm consensus that anthropogenic activities have transformed the original vegetation through agricultural and pastoral practices, the degree to which closed-canopy forest extended from the east to the west remains debated. Phylogenetic and population genetic patterns in a five-species clade of mouse lemurs suggest that longitudinal dispersal across the island was readily achieved throughout the Pleistocene, apparently ending at ∼55 ka. By examining patterns of both inter- and intraspecific genetic diversity in mouse lemur species found in the eastern, western, and Central Highland zones, we conclude that the natural environment of the Central Highlands would have been mosaic, consisting of a matrix of wooded savanna that formed a transitional zone between the extremes of humid eastern and dry western forest types

Pattern-Sensitive Epilepsy. I: A Demonstration of a Spatial Frequency Selective Epileptic Response to Gratings

Rare individuals suffer epileptic seizures when they view certain images, particularly stripes. Contrast-threshold functions (the ability to see faint stripes of various widths) were determined for two pattern-sensitive brothers, and the epileptogenicity of various patterns was assessed for one of them. Sine wave grating contrast-detection thresholds for the two subjects were essentially normal, with lowest thresholds at approximately 2 cycles/ degree (c/deg). Epileptiform discharges occurred maximally at 5 c/deg with a 1-octave 50% bandwidth. Pattern epileptogenicity was increased by the addition of a third harmonic sine wave grating to its fundamental, but was unaffected by the phase relation of the two gratings. The frequency selectivity of epileptic responsiveness was quantitatively similar to a “spatial frequency channel.” Inhibitory interactions were not present. The findings suggest relations between the phenomena of pattern-sensitive epilepsy and hypothesized spatial frequency channels which merit further exploration. RESUMEN De manera excepcional, hay personas que pueden tener ataques epilÉpticos cuando ven ciertas imÁgenes, particularmente rayas. Se determinaron los umbrales para contrastes (la capacidad de ver rayas de diversas anchuras y muy tenues) en dos hermanos sensibles a patrones y se estableciÓ la epileptogeneidad de di versos patrones en uno de ellos. Los umbrales para contrastes fueron esencialmente normales en los dos sujetos cuando se utilizeÓ una rejilla hecha con ondas sinusoidales, siendo el umbral inferior unos 2 ciclos/ grado (c/deg). Descargas epileptiformes tuvieron lugar de modo mÁximo a 5 c/deg con una amplitud de banda del 50% de una octava. la capacidad epileptogÉnica del partÓn aumentÓ cuando se aÑadiÓ una tercera sinusoide armÓnica a la rejilla base pero esa capacidad no se viÓ alterada por la relaciÓn de fase entre las dos rejillas. La selectividad de la frecuencia de la respuesta epileptogÉnica fue cuantitativamente similar al “canal de frecuencia espacial”. No se observaron interacciones inhibitorias. Los hallazgos sugieren que hay relaciones entre la epilepsyÍa secundaria a patrones visuales y los hipotÉticos canales de frecuencia espacial, lo cual merece mÁs investigaciÓn.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/65270/1/j.1528-1157.1980.tb04075.x.pd