371 research outputs found
Erosion of Trust in the Medical Profession in India : Time for Doctors to Act
In India, over the last decade, a series of stewardship failures in the health system, particularly in the medical profession, have led to a massive erosion of trust in these institutions. In many low- and middle-income countries (LMICs), the situation is similar and has reached crisis proportions; this crisis requires urgent attention. This paper draws on the insights from the recent developments in India, to argue that a purely control-based regulatory response to this crisis in the medical profession, as is being currently envisaged by the Parliament and the Supreme Court of India, runs the risk of undermining the trusting interpersonal relations between doctors and their patients. A more balanced approach which takes into account the differences between system and interpersonal forms of trust and distrust is warranted. Such an approach should on one hand strongly regulate the institutions mandated with the stewardship and qualities of care functions, and simultaneously on the other hand, initiate measures to nurture the trusting interpersonal relations between doctors and patients. The paper concludes by calling for doctors, and those mandated with the stewardship of the profession, to individually and collectively, critically self-reflect upon the state of their profession, its priorities and its future direction
Sub-Sets of Cancer Stem Cells Differ Intrinsically in Their Patterns of Oxygen Metabolism
PMCID: PMC3640080This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Precision Spectroscopy and Higher Spin symmetry in the ABJM model
We revisit Kaluza-Klein compactification of 11-d supergravity on S^7/Z_k
using group theory techniques that may find application in other flux vacua
with internal coset spaces. Among the SO(2) neutral states, we identify
marginal deformations and fields that couple to the recently discussed
world-sheet instanton of Type IIA on CP^3. We also discuss charged states, dual
to monopole operators, and the Z_k projection of the Osp(4|8) singleton and its
tensor products. In particular, we show that the doubleton spectrum may account
for N=6 higher spin symmetry enhancement in the limit of vanishing 't Hooft
coupling in the boundary Chern-Simons theory.Comment: 44 page
Synthesis and properties of graphene and graphene/carbon nanotube-reinforced soft magnetic FeCo alloy composites by spark plasma sintering
The effect of the addition of graphene nanoplatelets (GNP) and graphene nanoplatelet/carbon nanotube (GNT) mixtures on the mechanical and magnetic properties of spark plasma sintered soft magnetic FeCo alloys was studied. Three different volume fractions (0.5, 1 and 2 vol%) of GNPs and GNTs were investigated. Ball milling was used to disperse the GNPs in monolithic FeCo powder, while magnetic stirring and ultrasonic agitation were used to prepare hybrid GNT prior to ball milling. The highest saturation induction (B sat) of 2.39 T was observed in the 1 vol% GNP composite. An increase in the volume fraction of the ordered nanocrystalline structure was found to reduce the coercivity (H c) of the composites. The addition of CNTs to the GNP composite prevented grain growth, leading to grain refinement. An 18 % increase in hardness was observed in the 1 vol% GNP composite as compared to the as-received FeCo alloy. A reduction in tensile strength was observed in all of the composite materials, except for the 0.5 vol% GNT composite, for which a value of 643 MPa was observed. Raman spectroscopy indicated a reduction in the defect density of the GNPs after adding CNTs
Systematic review and meta-analysis of the diagnostic accuracy of ultrasonography for deep vein thrombosis
Background
Ultrasound (US) has largely replaced contrast venography as the definitive diagnostic test for deep vein thrombosis (DVT). We aimed to derive a definitive estimate of the diagnostic accuracy of US for clinically suspected DVT and identify study-level factors that might predict accuracy.
Methods
We undertook a systematic review, meta-analysis and meta-regression of diagnostic cohort studies that compared US to contrast venography in patients with suspected DVT. We searched Medline, EMBASE, CINAHL, Web of Science, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, Database of Reviews of Effectiveness, the ACP Journal Club, and citation lists (1966 to April 2004). Random effects meta-analysis was used to derive pooled estimates of sensitivity and specificity. Random effects meta-regression was used to identify study-level covariates that predicted diagnostic performance.
Results
We identified 100 cohorts comparing US to venography in patients with suspected DVT. Overall sensitivity for proximal DVT (95% confidence interval) was 94.2% (93.2 to 95.0), for distal DVT was 63.5% (59.8 to 67.0), and specificity was 93.8% (93.1 to 94.4). Duplex US had pooled sensitivity of 96.5% (95.1 to 97.6) for proximal DVT, 71.2% (64.6 to 77.2) for distal DVT and specificity of 94.0% (92.8 to 95.1). Triplex US had pooled sensitivity of 96.4% (94.4 to 97.1%) for proximal DVT, 75.2% (67.7 to 81.6) for distal DVT and specificity of 94.3% (92.5 to 95.8). Compression US alone had pooled sensitivity of 93.8 % (92.0 to 95.3%) for proximal DVT, 56.8% (49.0 to 66.4) for distal DVT and specificity of 97.8% (97.0 to 98.4). Sensitivity was higher in more recently published studies and in cohorts with higher prevalence of DVT and more proximal DVT, and was lower in cohorts that reported interpretation by a radiologist. Specificity was higher in cohorts that excluded patients with previous DVT. No studies were identified that compared repeat US to venography in all patients. Repeat US appears to have a positive yield of 1.3%, with 89% of these being confirmed by venography.
Conclusion
Combined colour-doppler US techniques have optimal sensitivity, while compression US has optimal specificity for DVT. However, all estimates are subject to substantial unexplained heterogeneity. The role of repeat scanning is very uncertain and based upon limited data
Limits on WWZ and WW\gamma couplings from p\bar{p}\to e\nu jj X events at \sqrt{s} = 1.8 TeV
We present limits on anomalous WWZ and WW-gamma couplings from a search for
WW and WZ production in p-bar p collisions at sqrt(s)=1.8 TeV. We use p-bar p
-> e-nu jjX events recorded with the D0 detector at the Fermilab Tevatron
Collider during the 1992-1995 run. The data sample corresponds to an integrated
luminosity of 96.0+-5.1 pb^(-1). Assuming identical WWZ and WW-gamma coupling
parameters, the 95% CL limits on the CP-conserving couplings are
-0.33<lambda<0.36 (Delta-kappa=0) and -0.43<Delta-kappa<0.59 (lambda=0), for a
form factor scale Lambda = 2.0 TeV. Limits based on other assumptions are also
presented.Comment: 11 pages, 2 figures, 2 table
Search For Heavy Pointlike Dirac Monopoles
We have searched for central production of a pair of photons with high
transverse energies in collisions at TeV using of data collected with the D\O detector at the Fermilab Tevatron in
1994--1996. If they exist, virtual heavy pointlike Dirac monopoles could
rescatter pairs of nearly real photons into this final state via a box diagram.
We observe no excess of events above background, and set lower 95% C.L. limits
of on the mass of a spin 0, 1/2, or 1 Dirac
monopole.Comment: 12 pages, 4 figure
The Dijet Mass Spectrum and a Search for Quark Compositeness in bar{p}p Collisions at sqrt{s} = 1.8 TeV
Using the DZero detector at the 1.8 TeV pbarp Fermilab Tevatron collider, we
have measured the inclusive dijet mass spectrum in the central pseudorapidity
region |eta_jet| < 1.0 for dijet masses greater than 200 Gev/c^2. We have also
measured the ratio of spectra sigma(|eta_jet| < 0.5)/sigma(0.5 < |eta_jet| <
1.0). The order alpha_s^3 QCD predictions are in good agreement with the data
and we rule out models of quark compositeness with a contact interaction scale
< 2.4 TeV at the 95% confidence level.Comment: 11 pages, 4 figures, 2 tables, submitted to Phys. Rev. Let
Search for High Mass Photon Pairs in p-pbar --> gamma-gamma-jet-jet Events at sqrt(s)=1.8 TeV
A search has been carried out for events in the channel p-barp --> gamma
gamma jet jet. Such a signature can characterize the production of a
non-standard Higgs boson together with a W or Z boson. We refer to this
non-standard Higgs, having standard model couplings to vector bosons but no
coupling to fermions, as a "bosonic Higgs." With the requirement of two high
transverse energy photons and two jets, the diphoton mass (m(gamma gamma))
distribution is consistent with expected background. A 90(95)% C.L. upper limit
on the cross section as a function of mass is calculated, ranging from
0.60(0.80) pb for m(gamma gamma) = 65 GeV/c^2 to 0.26(0.34) pb for m(gamma
gamma) = 150 GeV/c^2, corresponding to a 95% C.L. lower limit on the mass of a
bosonic Higgs of 78.5 GeV/c^2.Comment: 9 pages, 3 figures. Replacement has new H->gamma gamma branching
ratios and corresponding new mass limit
Dual echo positive contrast bSSFP for real-time visualization of passive devices duringmagnetic resonance guided cardiovascular catheterization
- …